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  "documentTitle": "Nevro Corp. (NVRO)",
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  "authorName": "Kir Kahlon",
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  "presentationDate": "2021-01-07 00:00:00",
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      "text": "KOL’s and ex-employees were remarkably consistent, across several dozen interviews, in explaining why Nevro’s sales growth collapsed – yet we failed to see one instance of device failures, lack of efficacy, and explants being asked about or mentioned in ~5 years of earnings calls or effusive sell-side reports.",
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      "text": "KOL's and ex-employees were remarkably consistent, across several dozen interviews, in explaining why Nevro's sales growth collapsed – yet we failed to see one instance of device failures, lack of efficacy, and explants being asked about or mentioned in ~5 years of earnings calls or effusive sell-side reports. We quote 4 different high-volume KOL's below, each with an eerily similar experience, as we detail in case studies on pages 95-105.",
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      "kind": "quote",
      "text": "KOL #2, a former Nevro consultant, said the rapid drop-off in efficacy led doctors to sour on the device",
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      "kind": "quote",
      "text": "When Nevro launched in 2015, I was really interested in the data and how much better it worked than regular spinal cord stimulation. So I used it and was very impressed in the beginning. But then the failures just kept coming. People just kept getting explanted or the pain just kept coming back ...After three to six months it was like clockwork that patients just started shitting the bed. So I just stopped using it...It was between three to six months almost across the board...I didn't have a single patient that made it past a year ...I might have 2 back patients that still have it out of 90 I implanted with Nevro. That's not unheard of. There are a lot, a lot, of doctors who have had that experience. I know of a lot of doctors who had a 70-80% explant rate. My overall explant rate is very low. No one can say that my Nevro explants were due to my patient selection.",
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      "text": "I've consulted at length for Boston Scientific, Abbott, Nuvectra, and of course `Nevro over the course of my career. I have been doing implants for 20 years. I've put in probably several thousand...What I noticed is that initially almost everybody did really well and subsequently there was a big fall off. We would hold round tables where we would have 15 implanter leaders and I and two other moderators would talk about the space in general and I found that I was not alone and that other busy implanters also had the same experience, where initially things looked good and then there was a significant drop off to where many doctors were hesitant to use the product.",
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      "kind": "quote",
      "text": "KOL #1 stated that the device stops working in months, with almost all of his Nevro implants explanted, and that other doctors have had 70-80% explant rates",
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      "text": "When Nevro launched in 2015, I was really interested in the data and how much better it worked than regular spinal cord stimulation. So I used it and was very impressed in the beginning. But then the failures just kept coming. People just kept getting explanted or the pain just kept coming back ...After three to six months it was like clockwork that patients just started shitting the bed. So I just stopped using it...I didn't have a single patient that made it past a year ...I might have 2 back patients that still have it out of 90 I implanted with Nevro. That's not unheard of. There are a lot, a lot, of doctors who have had that experience. I know of a lot of doctors who had a 70-80% explant rate. My overall explant rate is very low. No one can say that my Nevro explants were due to my patient selection. — KOL #1",
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      "text": "Source: Consultation calls with experts",
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      "kind": "title",
      "text": "Scorpion Capital | Nevro (NYSE: NVRO)",
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      "kind": "title",
      "text": "1. Introduction to Nevro",
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